The Therapeutic and Beneficial Value
of Pet Companionship
By Myrtle A. Klauer, ADC, CAP and Traci Pareti, CTRS

The introduction of a pet companionship program takes research, planning, policy
writing, and constant follow through. It takes a committed team to develop and support
this type of program. Almost any activity professional can share stories about residents
who refused to enter the nursing home until they found a good home for their cherished
pet. If the families couldn’t take the animal then one of the staff volunteered to give the
pet a good home. Once the resident settled into his or her new surroundings, the family
or staff member would bring the resident’s pet to the facility for regular visits.

There are many ways of incorporating pet interaction in a health care setting. It takes
time to get the residents, families, volunteers, and staff ready to welcome a pet
companion into their home, but it’s well worth the time investment. This article will
share ways to enhance pet interaction with the residents and discuss the therapeutic
benefits of pet facilitated therapy and pet companionship.

What the Research Reveals
The media sometimes portrays life in a nursing home as lonely, repetitive, and boring.
The culture change movement, introduced by the Pioneer Network and supported by the
Centers for Medicare and Medicaid Services (CMS), is changing this perception through
the introduction of pets and other aspects of life in the community into health care
settings. CMS encourages the introduction of animal companions and pets in nursing
homes because of the many benefits for the residents.

Providing nursing home residents with opportunities to interact with animals has
proven to significantly improve their quality of life and general sense of well-being.
Research has revealed that interaction with animals can lower one’s blood pressure;
reduce bad cholesterol levels; raise good cholesterol levels; and relieve symptoms of
depression.

According to Peter Lopatin’s article, Animals Put the "Home" Back Into Nursing Homes,
written in December 2008 for the Web site, WebVet (http://webvet.com/main/article?
id=2015), “The presence of animals infuses nursing home environments with life and
brings demonstrable medical benefits, including reduced depression and lower blood
pressure. Perhaps just as important is the boost to the residents’ self-esteem
experienced when they provide some of the care for the animal.” The emotional benefits
of having pets are difficult to measure because pets help human beings without anyone
knowing exactly why or how. What experts do know, however, is that pets and
companion animals can help individuals focus, if only for a short period of time, on
something other than themselves. Pets are one of nature's best sources of affection
and unconditional love.

Residents who help care for and/or interact with a pet may demonstrate a renewed
sense of purpose and well-being. An animal companion can take the resident’s mind
off his or her feelings of loneliness, grief, pain, boredom, anxiety, and fear. Petting a cat
or dog has been shown to lower one’s blood pressure by calming and relaxing the
individual. A pet’s antics can also provide opportunities for the residents to laugh and
interact with each other. Pets also encourage physical activity and enhance the
residents’ overall quality of life.

Amazing Stories
You hear stories of compassion and heroic actions that can be directly attributed to
animals. One such story comes from Betty White, an actress, television personality, and
animal advocate. This is a story about a Persian cat named Handsome, who was taken
by the staff of a local animal shelter to visit the residents in a nursing home. While
visiting there, Handsome met Marie, a lonely senior with no friends or family nearby.
Since her admission, Marie had isolated herself. She spent her days on her bed, curled
up in a fetal position, and not interacting with anyone. It was obvious to the nursing
home staff that Marie had lost her will to live. It wasn’t long before she had sores all
over her legs from constant scratching. Marie responded so well to Handsome’s visit
that the staff decided to adopt him and encourage Marie to interact with him. It wasn’t
long before Handsome and Marie became “roommates!” Handsome spent hours
purring at Marie’s side and whenever Marie tried to scratch her legs, the cat would play
with her hands or try other antics to distract her. Within a month the sores on her legs
had healed. Even more incredible is what happened next. Marie was so fascinated with
the cat that she began to communicate with the staff and other residents who came to
her room to visit “her” cat. Perhaps you have heard the story of Oscar, a domestic short-
hair cat, who lives in a nursing home in Rhode Island. He had been adopted by a
hospice agency when he was just a kitten.  It seems that Oscar has a very unique
talent. Oscar can sense when an individual is near the end of his or her life. He enters a
dying resident’s room a few hours prior to death and curls up next to the resident. Oscar
snuggles as close as he can get and begins to purr as loud as he can. So far he has a
perfect record -- 25 out of 25.  The nurses say Oscar is much more accurate than they
are or even the doctors. Since this is a terminal care facility for people with Alzheimer’s
disease, the residents may, or may not, be aware of the purring cat curled up next to
them. When the staff sees Oscar curled up next to a resident, they immediately call the
family to alert them, so they can come to the facility to say their final goodbyes.

Infection Control Issues to Be Considered
Infection control is an important issue to consider when thinking about adopting a cat,
dog, or even exotic birds for your facility. This issue also affects the pets that are brought
into the facility by family members and volunteers. The following are things you need to
know:
•        All employees and volunteers need to make sure the animals are not in areas
where food is being prepared or served. Cats and dogs can easily be trained to stay out
of these specific areas.
•        All employees and volunteers need to be aware of the residents who have
allergies to animals and respect these residents’ quality of life by keeping the animals
a safe distance away. Everyone must wash their hands thoroughly and brush any fur off
their clothes before entering these residents’ rooms.
•        Sick pets should not be allowed to visit residents under any circumstances. A sick
pet living in the facility should be quarantined and taken to a veterinarian immediately.
•        Teach the facility’s pet(s) not to dig in the trash or eat items found on the floor. This
is for the animal’s safety as well as the residents’.
•        Teach the facility’s pet(s) not to jump up on residents’ laps, beds, or other furniture.
•        Teach the facility’s pet(s) not to lick the residents.

The previous two points should also be strictly enforced for all visiting pets, not just the
pets that live in the facility.

Isolation Precautions: To Visit or Not to Visit
Animals can contract many infections and diseases human beings can develop;
therefore, pets should not be allowed to visit residents who are on isolation precautions
or in isolation rooms. This includes, but is not limited to: Amebiasis, Aureus,
Campyobacter, Giardia, Group A Strep, MRSA, C-Diff, Ringworm, Salmonella, Shigella,
Staph, Tuberculosis, and Viral Hepatitis.

Laying the Groundwork
Adopting a facility pet takes a great deal of preparation. If you plan on adopting a dog or
cat, ask a veterinarian to recommend a breed that is best for individuals with allergies
and has a docile temperament. Also ask about the kind of day-to-day care the pet will
require; when health visits to a vet are required or suggested -- including injections; and
training/house-breaking techniques that work best for the animal you plan on getting.
Be realistic about, and discuss, the ongoing costs of having an animal. (Some vets will
give nursing home pets routine office visits and inoculations at little or no cost.)

There are many dogs and cats in need of adoption, especially with this economic
downturn. Therefore, you should look into adopting an older cat or dog from your local
animal shelter. One benefit of adopting an older animal from a shelter is the knowledge
the shelter’s staff has about the animal’s history and behavior while in their care. Often
these animals have already been spaded or neutered. Since the older animals are
hard to place, the shelter may waive or reduce the adoption fee. If possible, arrange a
“trial adoption” for a specific amount of time, just in case the cat or dog has trouble
adjusting to the nursing home environment.

From my own experience, and after networking with other Activity Professionals, I
confirmed that most individuals will tolerate a dog; however, it’s not the same with a cat.
People either love cats or hate them -- there is no “gray area” when it comes to relating
to a cat! Therefore, before considering adopting a cat for your community, you need to
make sure everyone is in agreement to avoid adverse reactions. You’ll also need to
work with the administrator to decide which floor or unit the cat will live and provide
alternative work opportunities for those staff members who don’t like cats, if that’s the
animal you choose.

If the facility decides to adopt a dog, you’ll need to make sure there is an enclosed
outdoor area where the dog can exercise safely. You also need several individuals on
all three shifts who can walk the dog or put it into the outside enclosure to “do its
business.”

If you decide to adopt a cat, you’ll need to provide an enclosure for the litter box to
prevent the residents from coming into contact with the cat’s stool and urine. Several
staff volunteers on all shifts will need to be responsible for scooping, cleaning, and
refilling the litter box. If your maintenance department cannot make a suitable enclosure
for the litter box there are several companies that specialize in these types of
enclosures for nursing homes. Many litter box enclosures include enclosed spaces for
the food dishes, too. For examples, visit:
        
http://www.allpetfurniture.com/The-Refined-Feline-RLB-HO-TRF1017.html
        http://www.supercoolpets.com/archives/cat_litter_and_cleanup.php
        http://www.allpetfurniture.com/Cat-Litter-Boxes-and-Enclosures-C157655.html

No matter which companion animal you choose, you’ll need several volunteers to take
responsibility for feeding, watering, and cleaning up after the pet. Remember, the food
and water dishes will need to be protected to avoid the residents “sampling” the pet’s
food or placing something in the dish that’s not good for the pet. You’ll also need to
select a secure place where the animal can stay while becoming acclimated to the
facility. Once the pet has adjusted to its surroundings, the pet can be allowed to have
more (supervised) freedom on the unit or within the facility.  The next step is to meet
with the family members and staff on the floor or unit where the pet will reside to get
their input regarding the basic policies and procedures governing the addition of a
companion animal or pet-facilitated pet therapy program for the facility. When designing
a pet facilitated therapy program, you will need to incorporate some of the information
contained in this article and include these additional points:
•        A visiting animal must be on a leash or in a pet carrier while visiting the facility;
•        The animal’s owner must present a copy of the animal’s current inoculation record
and/or health certificate for the facility’s permanent file;
•        A staff member must accompany the animal during all visits, unless the animal
belongs to a resident’s family and is visiting that resident only; and
•        A designated staff member must provide a list of the rules for pet visits to the
animal’s owner. This staff person shall answer any questions the owner has before the
visit begins.

When there is a consensus in favor of acquiring a companion animal, the last step is to
notify all the families, staff, and volunteers of your decision. This letter should be sent to
the families and volunteers and placed in the employees’ pay envelope about two
weeks prior to the arrival of the companion animal. Include information about the benefit
of a pet for the residents and the animal’s “biography.” This notification is for the safety
of the staff, residents, families, volunteers, and companion animal.

Web Site Resources
The following Web sites contain valuable information about companion pets for
residents in nursing homes:
       
 http://www.kittykind.org/cc_adopting.html Myths About Adopting an Adult Cat
        http://www.helium.com/knowledge/191880-how-pets-bring-happiness-to-nursing-
homes, How Pets Bring Happiness to Nursing Homes
       
 http://www.nytimes.com/1986/06/01/nyregion/nursing-home-pets-a-boon-to-
residents. html, Nursing Home Pets: A Boon to Residents
        
http://www.mdpsych.org/SP01_gGodenne.htm, The Role of Pets in Nursing
Homes
       
 http://seniorjournal.com/NEWS/Eldercare/6-01-09-NursingHomeResidents.htm,
Nursing Home Residents Prefer Visits with Dogs, without People
Helpful References
1.        Hero Cats: True Stories of Daring Feline Deeds, by Eric Swanson, 1998
2.        Love, Miracles and Animal Healing, by Peter C. Jones, 1997
3.        Pawprints & Purrs, Inc., by a Private Not-for-Profit Shelter, 2009
4.        Dead Cat Walking, by Steven Joltin, 2007

Contact Information for Animal Assisted Therapy Groups
The following organizations can be a great help if you’re contemplating having a
certified therapy dog visit your facility or finding out more about having your facility’s dog
trained as a therapy dog:

Delta Society ~
www.deltasociety.org;
Therapy Dogs Incorporated ~
www.therapydogs.com; and
Therapy Dogs International ~
www.tdi-dog.org

Tantalizing Treats for Canines
To supplement the budget allotted for your companion animal, you might try making
some of these easy recipes for doggy treats and selling them as a fundraiser. The
residents will enjoy making these as one way of helping with the care and feeding of
their pet. The finished product can also be enjoyed by your canine pet. Making doggie
treats can also be a great community service project for a local animal shelter.

Easy Dog Biscuits
Ingredients:
  • 2 cups of unbleached, all-purpose flour                
  • 1 tablespoon of garlic powder
  • ½ cup wheat germ                                                      
  • 3 tablespoons of vegetable oil
  • ½ cup of brewer’s yeast                                             
  • 1 cup of chicken broth
  • 1 teaspoon salt
Directions:
1.        Preheat the oven to 375º F.
2.        Grease or oil 2 large baking sheets
3.        In a large mixing bowl, stir together the oil and garlic
4.        Combine the other dry ingredients in a separate bowl
5.        Slowly add these dry ingredients into the oil-garlic mixture while adding the broth
gradually to keep the mixture moist
6.        Roll the dough out on a floured surface to ¼ inch thickness
7.        Cut out shapes with cookie cutters
8.        Bake on the prepared baking sheets for 20 - 25 minutes, or until brown around
the edges
9.        Allow to air dry for 2 hours before storing or packaging in plastic bags for sale

“Bone Appetite” - Cheesy Treats
Ingredients:
  • 4 cups of whole wheat flour                
  • 1 can of cheese soup
  • 1 stick of butter                                
  • ½ cup of wheat germ
  • 2 cloves of garlic                               
  • 2 tablespoons of molasses
Directions:
1.        Preheat the oven to 375º F.
2.        Mix all the ingredients together
3.        Knead the dough on a floured surface
4.        Roll out to ¼ inch thickness
5.        Cut the dough with cookie cutters or a knife
6.        Bake these treats at 375º F. on an ungreased baking sheet for 20 minutes
7.        Turn the treats over and bake another 10 minutes
8.        Allow to air dry for 2 hours before storing or packaging in plastic bags for sale

Microwave Doggie Doughnuts
Ingredients:
  • 2 cups whole wheat flour                        
  • 2 tablespoons of oatmeal
  • 1 egg, slightly beaten                        
  • 1 teaspoon of garlic powder
  • 2/3 cup of chicken or beef broth
Directions:
1.        Place flour in a large bowl
2.        Add the egg and broth
3.        Mix well
4.        Blend in the oatmeal
5.        Add the garlic powder
6.        Roll dough into a ball
7.        Roll out the ball of dough on a lightly floured surface to a round, which is about ½
inch thick
8.        Cut the dough with small doughnut cutters into donut rings
9.        Remove the doughnut holes before placing on the baking dish
10.        Shape the remaining scrapes of dough by hand
11.        Arrange the rings in a single layer on a shallow baking pan lined with a sheet of
parchment paper
12.        Cook on high for 10 minutes, or until firm (Microwaves vary, so watch closely
and rotate the doggie doughnuts halfway through the suggested cooking time)
13.        Place on a rack and allow to cool
14.        Store in a covered container or package in plastic bags for later sale

Additional recipes can be found at:
www.gourmetsleuth.com/recipe_dogbiscuit.
Investing time researching companion pets and pet assisted therapy prior to acquiring
an animal for your community, will help make your program a success. Develop clear
policies and procedures and provide information about the animal(s) involved in the
program or coming to live at the facility. Remember to include the residents, families,
and staff as much as possible in the entire process. Seeing the smiles on the
residents’ faces as they interact with their pet is very special!
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